A large European multicenter study compared the efficacy and safety of Tacrolimus versus the microemulsion formulation of Cyclosporine in 205 SPK recipients. All of the patients received additionally rabbit anti-T-cell induction therapy, MMF and short-term corticosteroids. The study showed a significantly higher pancreas graft survival rate with Tacrolimus (91%) than with Cyclosporine (74%; P<0.0005).3 A second US multicenter study focused on the effect of antibody induction therapy in SPK recipients. The trial conducted at 18 US pancreas transplant centers, randomized 87 recipients each to antibody induction therapy versus no therapy. In the induction group, either T-cell depleting or nondepleting antibodies were used. Maintenance therapy in both groups was Tacrolimus, MMF and steroids. At 3 years, actual patient survival rates (94% vs. 90%) and pancreas graft survival rates (76% vs. 76%) were similar between the two groups, but actual kidney survival rates were significantly higher in the induction group (92% vs. 82%; P=0.04).4 A third US-Canadian multicenter study assessed the safety and efficacy of two dosing regimens of daclizumab versus no antibody induction in 185 SPK recipients maintained on Tacrolimus, MMF and steroids. The probability of either kidney or pancreas rejection was lowest with two doses of daclizumab (P=0.042). The authors concluded that daclizumab is effective in reducing the incidence of acute rejection in SPK recipients, as compared with no antibody induction.5